How Common Really Is Prostate Cancer and How Easy Is it to Get Tested?
In the month of October, many organizations use the color pink to raise awareness for breast cancer. Women are encouraged to do regular home exams and to attend their annual mammograms.
For men, prostate cancer is also common. But there isn’t the same awareness campaign and encouragement for men to get regular screenings. That’s because the scientific community doesn’t agree — do prostate cancer screenings save lives? Or cause unnecessary problems?
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What Is Prostate Cancer?
The prostate is a gland found in male mammals, and it is an internal part of the male reproductive system. In humans, the prostate is about the size of a chestnut, and it weighs around an ounce. It is located below the bladder and behind the rectum.
The prostate has several functions, including producing a fluid found in semen and then working to push semen through the urethra. As men age, their prostates naturally become larger. Some develop benign growths that may press against the bladder and cause problems with urination.
Prostate cancer occurs when malignant tumors develop in the prostate. It is the most common type of cancer in men, after non-melanoma skin cancer. The most recent data from the Centers for Disease Control and Prevention (CDC) reports that 255,395 men were diagnosed with prostate cancer in 2022, and 33,881 died.
Most men survive prostate cancer, and 75 percent are diagnosed with having a “localized” cancer, meaning it hasn’t spread. For one-third of diagnoses, oncologists recommend ongoing surveillance with regular testing and imaging to make sure the tumor isn’t advancing. More advanced diagnoses may require surgery, radiation, and testosterone-suppressing drugs.
Is Prostate Cancer Common?
Diagnosing prostate cancer is easy, which may be why it is the second most common cancer in men.
“We are looking for prostate cancer, and so you are going to find more prostate cancer,” says Ruben Raychaudhuri, a medical oncologist with the Fred Hutchinson Cancer Center and an assistant professor at the University of Washington School of Medicine.
A prostate-specific antigen (PSA) screening identifies the amount of PSA in a man’s blood. An elevated PSA level may be indicative of cancer.
“We think about prostate cancer as a spectrum,” Raychaudhuri says. “Not all prostate cancers need to be treated. You check a PSA level, and it’s elevated. Just because you find something that looks like cancer doesn’t mean it’s going to be a problem.”
To Test or Not to Test for Prostate Cancer
Prostate cancer is a slow-growing cancer, and for some men, Raychaudhuri says, it may not cause problems in their lifetime. Oncologists consider the PSA when making a treatment plan, but they also factor in the size and location of the tumor. They analyze the cancer cells under a microscope and consider whether the cancer cells are behaving aggressively.
In many instances, an oncologist will recommend long-term screening as opposed to medical interventions, which may cause side effects. Surgery risks long-term incontinence and erectile dysfunction. Radiation can cause damage to the bladder or rectum, which could also cause incontinence.
“There is so much effort into figuring out which of these patients really need to have this dealt with or which we can safely watch and spare them from the toxicities of these treatments,” Raychaudhuri says.
Because many men don’t require treatment, the scientific community does not agree on PSA testing, whether it should be used in regular screening, and if so, at what age a man should begin.
“A lot of people have strong opinions both ways in regard to it,” Raychaudhuri says.
Those who favor screening argue that it can be used as a preventive tool to save lives. Those who are opposed say it leads to unnecessary anxiety for men who are diagnosed with prostate cancer that may not require immediate treatment.
“PSA can lead to increased anxiety and treatment complications while reducing prostate cancer-related mortality,” Raychaudhuri says.
This article is not offering medical advice and should be used for informational purposes only.
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